| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,975 |
1,902 |
$288K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,818 |
1,036 |
$217K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,868 |
1,650 |
$217K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,319 |
1,224 |
$165K |
| 59025 |
Fetal non-stress test |
797 |
415 |
$85K |
| 76813 |
|
375 |
350 |
$69K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
591 |
445 |
$52K |
| 80306 |
|
463 |
346 |
$40K |
| 76801 |
|
226 |
213 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
95 |
84 |
$14K |
| 76820 |
|
96 |
43 |
$11K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
231 |
219 |
$7K |
| 82950 |
|
169 |
168 |
$4K |
| 85018 |
|
179 |
170 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
32 |
24 |
$1K |
| 87653 |
|
12 |
12 |
$1K |
| 87077 |
|
24 |
24 |
$648.00 |